What is a hamstring strain? – Blog By Ryan Harris
A hamstring strain is a common lower limb injury. It occurs when there is a tear of one or more of the hamstring muscles. This can range from a mild tear involving only a few muscle fibres to a complete rupture of the muscle.
The hamstring muscles are located in the back of the thigh. There are 3 main muscles in the hamstring. Located medially are the semitendinosus and semimembranosus muscles. Biceps femoris consists of two muscle heads and is located laterally.
There are two types of hamstring strains, identified by the mechanism of the injury. It is important to distinguish the mechanism because it helps to predict the prognosis of the injury.
Type 1 – Sprinting related
Type 1 hamstring strains occur during high speed running. During the stride cycle, the hamstring is working hard to eccentrically slow the swinging tibia and control knee extension in preparation for contact with the ground. Type 1 hamstring strains typically recover quicker than type 2 strains, despite a greater initial decline in function.
Type 2 – Stretch related
Stretch related hamstring strains occur when excessive stretch in place upon the muscle. As a result, this more commonly occurs in sports like gymnastics and ballet. Whilst a type 2 strain does not have as much of an initial limitation in function when compared to type 1, the recovery is often longer.
A thorough examination from your physiotherapist will be able to diagnose a hamstring strain. Common signs include bruising, pain on hamstring contraction, reduced flexibility and a palpable lump or gap within the muscle.
Ultrasound scans and MRI are often used to help determine the location and severity of a hamstring strain. Depending on severity, hamstring strains can be graded 1, 2 or 3.
Grade 1 Hamstring Strain
With a grade 1 hamstring strain you have overstretched the muscle without tearing the muscle fibres. You can still walk and you may not feel the strain until after the activity. You will be aware of some hamstring discomfort and unable to run at full speed. There will be mild swelling and spasm. There is usually no strength or flexibility deficits.
Grade 2 Hamstring Strain
With a grade 2 hamstring strain you may limp when you walk and there are partial tears in the muscle. You will usually feel pain and twinges during activity. You may notice some hamstring muscle swelling and your hamstring will be tender to palpate. There will also be strength and flexibility deficits to the muscle.
Grade 3 Hamstring Strain
A grade 3 hamstring strain is a severe injury involving a full rupture or severe tear of the muscle. There may be a lump you can feel above where the depression is. Swelling will be noticeable immediately and bruising will usually appear below the injury site a day later. You may need crutches to walk and will feel severe pain and weakness in the muscle. These strains may require surgical intervention.
Diagnostic MRI may also be used to specifically identify the grade of hamstring tear and its exact location.
Your physiotherapist will conducted a thorough assessment of your hamstring to determine the type of severity on the injury.
Using this information, a structured treatment plan will be development, focusing on:
- Reducing hamstring pain,
- Restoring full range of motion of the muscle,
- Strengthening the hamstring muscles,
- Strengthening other contributing lower limb muscles,
- Enhancing lumbo-pelvic control and stability,
- Addressing any accompanying neural mobility restriction,
- Improve function and technique of sport specific activities,
- Reducing the likelihood of re-injury.
Hamstring injuries can be a recurrent problem. To reduce the risk of re-injury, it is imperative you follow the following recommendations.
- A proper warm up with sport specific drills is recommended
- Post cooling down period and stretching after activity
- Appropriate loading and speed programs
- Gradually increasing intensity of games prior to returning to sport
- Ensure appropriate foot biomechanics / gradual progression of playing surface
- Ensure appropriate strength between the hamstring and the quadriceps.
At Total Physiocare, we have a wealth of experience in sporting injuries and management.
Post by Ryan Harris (Physiotherapist)